Where Do Obama and McCain Stand on LTC, Social Security?

With the elderly population growing by leaps and bounds, families are struggling with long-term care costs and worrying about Social Security. So what are the presidential candidates' plans to address these issues? Below is a summary of the main party candidate's positions on some of the issues that affect seniors and their families.

Sen. Barack Obama

Sen. Obama has a section on his Web site devoted to seniors and Social Security. With regard to long-term care, Sen. Obama's Web site states that he "will work to give seniors choices about their care, consistent with their needs, and not biased towards institutional care. He will work to reform the financing of long term care to protect seniors and families. He will work to improve the quality of elder care, including by training more nurses and health care workers." His Web site also states that he will expand eligibility for Medicaid and ensure it continues to serve its critical safety net function.

In addition, Sen. Obama told the AARP he plans to propose tax code changes that would benefit family caregivers who often "are making substantial contributions without a lot of help." He has also announced that he will eliminate all income taxes on seniors making less than $50,000 per year.

Other proposals include allowing the federal government to negotiate for lower drug prices for the Medicare program, just as it does to lower prices for veterans. Sen. Obama also supports allowing seniors to import safe prescription drugs from overseas and preventing pharmaceutical companies from blocking cheap and safe generic drugs from the market.

With regard to Social Security, Sen. Obama has called for a Social Security payroll tax on incomes above $250,000 a year to begin in 2019. Currently the tax is levied only on the first $102,000 of each worker's income. He would not impose the tax on incomes between $102,000 and $250,000.

For more on Sen. Obama's proposals for seniors, go to: www.barackobama.com/issues/socialsecurity/.

Sen. John McCain

On Sen. McCain's Web site, he states there is a need to develop a strategy for meeting growing long-term care needs. His Web site mentions state-based experiments such as Cash and Counseling or The Program of All-Inclusive Care for the Elderly (PACE) that "are pioneering approaches for delivering care to people in a home setting."

Sen. McCain's Web site states that he wants to "reform the payment systems in Medicaid and Medicare to compensate providers for diagnosis, prevention and care coordination. Medicaid and Medicare should not pay for preventable medical errors or mismanagement." To that end, Sen. McCain has proposed a major overhaul of Medicare's payment system to pay health care providers by how successfully they treat their patients instead of by each individual service they perform. He has also suggested making wealthier Medicare beneficiaries pay more for their benefits. Specifically he has proposed higher Medicare Part D premiums for couples making more than $160,000 a year.

With regard to caregivers, Sen. McCain told the AARP that he believes that decisions about the care of older family members should remain within each family, and "any way we can help caregivers [offset costs through tax credits or other financial incentives] we should. But it needs to be part of an overall policy regarding health care."

Sen. McCain states that he has said he would consider "almost anything" to help Social Security except higher payroll taxes. According to his Web site, Sen. McCain "supports supplementing the current Social Security system with personal accounts."

For more on Sen. McCain's proposals on health care www.johnmccain.com/Informing/Issues/19ba2f1c-c03f-4ac2-8cd5-5cf2edb527cf.htm.

For the Kaiser Family Foundation's side-by-side comparisons of the candidates' positions on key health care issues, including long-term care, Medicare and prescription drugs, click here.

For New York Times blogger Jane Gross's comparisons of Obama and McCain on long-term care issues, click here.